pharm exam 5 practice questions

sympathomimetics shouldnt be taken more than

5 days

if a LABA is being used to treat asthma it must ALWAYS be combined with

a glucocorticoid

what are three COPD treatment options

- anticholinergic medications - long acting beta 2 agonists - glucocorticoids

what are the three treatment options for asthma

-Short Acting beta 2 agonists -inhaled glucocorticoid -long acting beta 2 agonists

A nurse is caring for a client who had asthma and taking fluticasone. The nurse should monitor for which adverse effect? a. hypoglycemia b. hypertension c. polyuria d. oral candidiasis

. oral candidiasis

With sildenafil, plasma levels peak in

1 hour

Levothyroxine should be taken in the morning at least

30 to 60 minutes before breakfast on an empty tummy and shouldn't be given with other meds

Patients should separate administration of levothyroxine and any med that interacts with it by at least

4 hours

The nurse instructs a patient in the use of combination oral contraceptives for birth control. The nurse determines that teaching is successful if the patient makes which statement? A. "I'll avoid herbal products such as St. John's wort." B. "Birth control pills don't have serious side effects." C. "I can continue taking birth control before elective surgeries." D. "I should take the pill with food to prevent an upset stomach."

A. "I'll avoid herbal products such as St. John's wort."

The nurse identifies which female patient has the least risk for developing complications when hormone therapy is prescribed? A. A 45-year-old patient who takes estrogen after a hysterectomy B. A 55-year-old patient who takes estrogen combined with progestin C. A 58-year-old patient with osteopenia who takes hormone therapy D. A 60-year-old patient with a family history of breast cancer

A. A 45-year-old patient who takes estrogen after a hysterectomy

Constipation is a common adverse effect.A patient is taking finasteride [Proscar] for benign prostatic hyperplasia (BPH). The nurse should explain that this medication has what effect? A. Decreases the size of the prostate gland. B. Relaxes smooth muscle of the prostate gland. C. Reduces the risk of prostate cancer. D. Improves sexual performance during intercourse.

A. Decreases the size of the prostate gland.

A patient is prescribed codeine as an antitussive. Which symptom will the nurse observe for as an adverse effect of this medication? A. Respiratory depression B. Increased heart rate C. Productive cough D. Restlessness

A. Respiratory depression

A patient is prescribed NPH insulin. Which statement should the nurse include in the discharge instructions? A. The insulin will have a cloudy appearance in the vial. B. The onset of action is rapid. C. The patient should not mix Lantus with short-acting insulin. D. The patient will have no risk of allergic reactions with this insulin.

A. The insulin will have a cloudy appearance in the vial.

The nurse instructs a patient about taking levothyroxine [Synthroid]. Which statement by the patient indicates the teaching has been effective? A. "To prevent an upset stomach, I will take the drug with food." B. "If I have chest pain or insomnia, I should call my doctor." C. "This medication can be taken with an antacid." D. "The drug should be taken before I go to bed at night."

B. "If I have chest pain or insomnia, I should call my doctor."

The nurse teaches a group of postmenopausal women about hormone therapy (HT). Which information should the nurse include in the teaching plan? A. The most frequent adverse effect of HT is headache. B. HT increases the risk of stroke and venous thromboembolism. C. Blood levels of estrogen are more consistent with oral HT. D. HT may cause a harmless yellow discoloration of the skin.

B. HT increases the risk of stroke and venous thromboembolism.

The nurse is planning an educational program on sildenafil to a group of older male clients. Which of the following info should the nurse include in the educational program? A.Swallow the med with grapefruit juice B. Ingestion of med with nitrates cause hypotension c. take med 2 hrs prior to sexual activity d. consume high fat meal with med to increase absorption

B. Ingestion of med with nitrates cause hypotension

A patient is prescribed metformin. Which statement about metformin does the nurse identify as true? A. Metformin increases absorption of vitamin B12. B. Metformin can delay the development of type 2 diabetes in high-risk individuals. C. Metformin causes patients to gain weight. D. Metformin use predisposes patients to alkalosis.

B. Metformin can delay the development of type 2 diabetes in high-risk individuals.

A patient is prescribed insulin glargine [Lantus]. Which statement should the nurse include in the discharge instructions? A. The insulin will have a cloudy appearance in the vial. B. Once daily at bedtime. C. The patient should mix Lantus with the intermediate-acting insulin. D. The patient will have less risk of hypoglycemic reactions with this insulin.

B. Once daily at bedtime.

A patient takes levothyroxine [Synthroid] 0.75 mcg every day. It is most appropriate for the nurse to monitor which laboratory test to determine whether a dose adjustment is needed? A. Thyrotropin-releasing hormone (TRH) B. Thyroid-stimulating hormone (TSH) C. Serum free T4 test D. Serum iodine level

B. Thyroid-stimulating hormone (TSH)

if you have a patient on Canaglifozin you should monitor

BP closely

A nurse is providing medication teaching to a 12-year-old male patient with hypogonadism. Which statement, made by the patient, indicates an understanding of the prescribed medication, testosterone enanthate? A. "I will grow significantly taller while taking this medication." B. "Sexual changes in my body will occur within 4 to 6 months." C. "I will come to the clinic every 2 weeks for shots of testosterone." D. "If the medication causes stomach upset, I can take it with food."

C. "I will come to the clinic every 2 weeks for shots of testosterone."

Which patient would be at greatest risk of developing a venous thromboembolism (VTE) if a combination oral contraceptive were prescribed? A. A 25-year-old patient who drinks 3 to 4 alcoholic drinks a day B. A 45-year-old patient who has a family history of stroke C. A 22-year-old patient who smokes 2 packs of cigarettes a day D. A 29-year-old patient who has used birth control pills for 9 years

C. A 22-year-old patient who smokes 2 packs of cigarettes a day

A patient has been prescribed sildenafil [Viagra] for erectile dysfunction. Which instruction should the nurse include in the teaching plan? A. Take the medication on an empty stomach. B. Drink plenty of fluids to prevent priapism. C. Avoid taking nitroglycerin with this drug. D. Constipation is a common adverse effect

C. Avoid taking nitroglycerin with this drug.

A patient asks what medication would be most effective in the treatment of seasonal hay fever. The nurse will teach the patient about the use of which drug? A. Azelastine [Astelin] B. Chlorpheniramine [Chlor-Trimeton] C. Fluticasone [Flonase] D. Pseudoephedrine [Sudafed]

C. Fluticasone [Flonase]

22. Which of the following is NOT a serious adverse effect of long-term oral glucocorticoid therapy? A. Adrenal suppression B. Osteoporosis C. Hypoglycemia D. Peptic ulcer disease

C. Hypoglycemia

A patient is taking estrogen daily. Which instruction by the nurse should be included to reduce the risk of a cardiovascular event, such as stroke or myocardial infarction? A. Reduce aerobic activities. B. Increase dietary intake of trans fat. C. Stop smoking. D. Take the medication with food.

C. Stop smoking.

Which information should the nurse include when teaching a patient about inhaled glucocorticoids? A. Inhaled glucocorticoids have many significant adverse effects. B. The principal side effects of inhaled glucocorticoids include hypertension and weight gain. C. Use of a spacer can minimize side effects. D. Patients should rinse the mouth and gargle before administering inhaled glucocorticoids.

C. Use of a spacer can minimize side effects.

A patient with asthma is prescribed albuterol [Proventil], 2 puffs every 4 hours as needed. The nurse should teach the patient to do what? A. Rinse the mouth after taking the prescribed dose. B. Take an extra dose if breathing is compromised. C. Wait 1 minute between puffs from the inhaler. D. Take adequate amounts of calcium and vitamin D.

C. Wait 1 minute between puffs from the inhaler.

A patient contacts a clinic nurse to determine the proper action after she forgot to take her oral contraceptive [Ortho Tri-Cyclen] for the past 2 days during the first week of a 28-day regimen. Which response by the nurse is most appropriate? A. "Take the omitted two doses together with the next dose." B. "Take two doses per day on the following 2 days." C. "Stop taking the oral contraceptive until menstruation occurs." D. "Take a dose now and continue with the scheduled doses."

D. "Take a dose now and continue with the scheduled doses."

The nurse teaches a patient about a Progesterone only pill, Camila. Which statement by the patient requires an intervention by the nurse? A. "I might have irregular bleeding while taking this pill." B. "These pills do not usually cause blood clots." C. "I should take this pill at the same time every day." D. "This pill works primarily by preventing ovulation."

D. "This pill works primarily by preventing ovulation."

A patient with hyperthyroidism is taking propylthiouracil (PTU). It is most important for the nurse to assess the patient for which adverse effects? A. Gingival hyperplasia and dysphagia B. Dyspnea and a dry cough C. Blurred vision and nystagmus D. Fever and sore throat

D. Fever and sore throat

A male patient is prescribed a topical testosterone gel [AndroGel]. It is most appropriate for the nurse to teach the patient to do what? A. Apply the gel to the genital area every morning. B. Leave the patch in contact with the skin for 24 hours. C. Avoid showering or swimming after gel application. D. Keep the treated area covered with clothing.

D. Keep the treated area covered with clothing.

Which statement regarding antihistamine administration to older adults does the nurse identify as true? A. Antihistamines cause CNS excitation in older adults. B. Larger doses of antihistamines are needed for older adults. C. Antihistamines can be used to reduce intraocular pressure. D. Older men with benign prostatic hypertrophy can experience worse symptoms when taking antihistamines.

D. Older men with benign prostatic hypertrophy can experience worse symptoms when taking antihistamines

A patient who takes over-the counter diphenhydramine [Benadryl] for seasonal allergy symptoms complains of drowsiness. What should the nurse do? A. Instruct the patient to drink caffeinated beverages. B. Recommend taking the medication with meals. C. Ask the patient's healthcare provider to prescribe hydroxyzine [Vistaril]. D. Tell the patient to take cetirizine [Zyrtec] instead of diphenhydramine.

D. Tell the patient to take cetirizine [Zyrtec] instead of diphenhydramine.

if a patient says they wont eat dinner, do you give them their insulin?

NO

Inhaled Glucocorticoids are known to cause

THRUSH: a bacterial infection that appears as white patches around mouth due to patients not rinsing mouth after use of inahler

A nurse is caring for a child who is experiencing status asthmaticus. Which of the following interventions is the priority for the nurse to take a. Admin a short acting B2-agonist (SABA) b. Obtain a peak flow reading c. Determine the cause of the acute exacerbation

a. Admin a short acting B2-agonist (SABA)

A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the follwoing actions by the client indicates an understanding of teaching? a. The client holds his breaths for 10 seconds after inhaling med b. the client takes a quick inhalation while releasing med from inhaler c. the client exhales as the med is released from inhaler

a. The client holds his breaths for 10 seconds after inhaling med

A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the clients blood glucose to be 48 mg/dL, he should give the patient... a. graham crackers b. 1 tsp sugar c. 4 oz diet soda d 4oz skin milk

a. graham crackers

A nurse in a providers clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which med currently prescribed to the client is a contraindication to taking sildenafil? a. isosorbide b. phenytoin c.metronidazole d. prednisone

a. isosorbide

A nurse is assessing a client with hypothyroidism. WHich of the following should the nurse expect? a. lethargy b. weight loss c. photophobia

a. lethargy

A nurse is providing teaching to a client who had a new diagnosis of type 2 diabetes. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (select all that apply) a. moist, clammy skin b. tachycardia c. polyuria d. blurred vision e. polydipsia

a. moist, clammy skin b. tachycardia d. blurred vision e. polydipsia

A nurse is teaching a client who has a new prescription for dimenhydrinate for motion sickness. Which of the following instructions should the nurse include? a. monitor for dizziness b. observe for diarrhea c. expect increase in salvation

a. monitor for dizziness

A nurse is teaching a client who is tking metformin XR for type 2 diabetes mellitus. Which of the following instructions should the nurse inclde? a. stop this med before exams that require contrast b. crush or chew the med c. the med may increase perspiration

a. stop this med before exams that require contrast

A nurse is assessing a client with type 1 diabetes mellitus and finds the patient lying in bed, sweating, and reporting feeling anxious. Which of the following complications should the nurse suspect? a.hypogyclemia b. Nephropathy c. hyperglycemia

a.hypogyclemia

A nurse is assessing a client with diabetes mellitus. WHich of the following findings is a manifestation of hypoglycemia? a bradycardia b. cool, clammy skin c. vomitting d. fruity odor of breath

b. cool, clammy skin

A nurse is preparing to admin 10 units of regular insulin and 20 units of NPH insulin to a client. Which sequence of events should the nurse follow? a.inspect vial for contaminants b. roll NPH vial between palm of hands c. add intermediate insulin to syringe d. Withdrawl short acting insulin into syringe e. inject air into regular insulin vial f. inject air into NPH insulin vial

a.inspect vial for contaminants b. roll NPH vial between palm of hands f. inject air into NPH insulin vial e. inject air into regular insulin vial d. Withdrawl short acting insulin into syringe c. add intermediate insulin to syringe

methimazoles biggest adverse effect is

agranulocytosis!

sildenafil can cause priapism, when is it really bad?

at 4 hours they should go to the hospital, 6 hours with an erection is really bad, and at 24 hours they may never be able to have sex again how sad lol

how long should a pt wait between inhaler puffs?

at least a minute

A nurse is teaching a client who has chronic obstructive pulmonary disease and is t start using fluticasone by MDI twice daily. Which of the following instructions shoukd the nurse include? a. check your HR before each dose b. Inspect mouth for lesions daily c. skip the morning dose if you dont have any symptoms

b. Inspect mouth for lesions daily

A nurse is caring for a female client in emergency department who reports shortness of breath and pain in lung areas. She states that she started taking birth control pills 3 weeks ago and that she smokes. Her HR is at 110/min, respiratory rate 40/min, and blood pressure 140/80. Her arterial blood gasses are ph 7.5, PaCO2 29mmHg, PaO2 60mmHg, HCO3 20mEq/L and SaO2 86%. Which of the following is the priority nursing intervention? a. prepare for mechanical ventilation b. admin oxygen via face mask c. prepare to admin a sedative

b. admin oxygen via face mask

A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the med. The nurse should explain to the client to reduce dose gradually to prevent... a. hyperglycemia b. adrenocortical insuffciency c. severe dehydration

b. adrenocortical insuffciency

A nurse is reviewing the health history of a client who has a new prescription for a combined oral contraceptive (COC). The nurse recognizes that which of the follwoing clients meds can interfer with the effectiveness? a. antihypertensives b. anticonvulsants c. antioxidants d. antiemetics

b. anticonvulsants

A nurse is caring for a client who is experiencing menopausal symptoms and asks the nurse about menopausal hormone therapy. The nurse should inform the client that HT is not recommended due to which of the following findings in the clients medical history? a. history of dermatitis b. history of breast cancer c. Multiple hospitalizations for COPD

b. history of breast cancer

A nurse is preparing to admin lispro insulin to a client who had type 1 diabetes. Which of the following actions should the nurse take? a. assess for hypoglycemia 4 hrs after injection b. inject 15 mins before meal c. monitor for polyuria d. admin with short acting insulin

b. inject 15 mins before meal

A nurse is taking.a client who had a new prescription for regular insulin and NPH insulin. What should the nurse include in the teaching? a. inject insulin into large muscle b. keep open vial at room temp c. aspirate the med prior to admin d. admin in 2 separate injections

b. keep open vial at room temp

A nurse is providing teaching to a client who had a new diagnosis of hypothyroidism. What med should the nurse prepare to instruct the client? a. Radioactive iodine b. levothyroxine c. sumatriptan d. levofloxacin

b. levothyroxine

A nurse is caring for a client who has type 1 diabetes. The nurse missread the clients morning Blood Glucose Level as 210 mg/dL instead of 120mg/dL and administered insulin dose appropriate for reading over 200 before breakfast. Which of the following should the nurse prioritize? a.give the client 15-20 g of carbs b. monitor for hypoglycemia c. complete incident report d. notify nurse manager

b. monitor for hypoglycemia

A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? Select all that apply a. The med will stimulate flow of mucus b. the med will prevent wheezing c. the med will decrease coughing episodes d. themed will reduce inflammation e. the med will open airways

b. the med will prevent wheezing c. the med will decrease coughing episodes e. the med will open airways

A nurse is teaching the parents of a child who is to start using a metered dose inhaler to treat asthma. Which of the following info should the nurse include? a. the spacer increases the amount of med delivered to the oropharynx b. the spacer increases the amount of med delivered to the lungs c. inhale rapidly

b. the spacer increases the amount of med delivered to the lungs

With oral glucocorticoids, you want to be sure your patient is tapering off of them, why?

because of the adrenal suppression...it takes months for it to work fully again

Montelukast or singulair is known to cause big

behavior changes in children

A nurse in an emergency department is caring for a child who is experiencing an acute asthma attack. Which of the following meds should the nurse admin first? a. fluticasone b. montelukast c albuterol

c albuterol

A nurse is reviewing contraception options for 4 clients. The nurse should identify that which of the following clients has a contraindication for receiving oral contraceptives? a. 26 yr old patient who had migraine headaches at the start of each period b. 28 yr old who has history of pelvic inflammatory disease c. 38 yr old who smokes 1 pack of cigs a day

c. 38 yr old who smokes 1 pack of cigs a day

A nurse is caring for a client who has diabetes and plans to admin his regular insulin subcutanously before he eats breakfast at 0800. After checking the clients morning glucose level which of the following actions should the nurse take? a. give insulin at 0700 b. give insulin when food arrives c. Give insulin at 0730

c. Give insulin at 0730

A nurse is teaching young women about the use of oral contraceptives. The nurse hsould teach that taking which of the following herbal preparations reduces effectiveness of birth control method? a. Ginseng b. Gingko Biloba c. St johns wort d. saw palmetto

c. St johns wort

A nurse at a family practice clinic receives a call from a client who is prescribes oral contraceptives but forgot to take one dose. The client reports she is in the first week of a 28 day cycle pack. Which of the following instructions should the nurse provide? a. do not have vaginal intercourse until after your next period b. stop taking the pills and switch to a different contraceptive method c. Take the missed dose now and continue med as ordered d. take a pregnacy test

c. Take the missed dose now and continue med as ordered

A nurse is talking with a client whose thyroid- stimulating hormone level will be measured.Which of the following statements by the nurse explains the purpose of this test? a. The test measures the amt of thyroid hormone that attaches to a protein in your blood b. This test detects antithyrioid antibodies c. This test determines whether your thyroid gland is over active, appropriately active or under active.

c. This test determines whether your thyroid gland is over active, appropriately active or under active.

A nurse in a clinic sees a client who has an acute asthma exacerbation. Which of the following meds should reduce the symptoms? a. cromolyn via metered dose inhaler b. montelukast orally c. abulterol via jet nebulizer

c. abulterol via jet nebulizer

A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following info should the nurse include? a. discard NPH solution if appears cloudy b. shake the insulin vigorously before loading the syringe c. expect NPH insulin to peak in 6-14 hrs d. freeze inslin vials

c. expect NPH insulin to peak in 6-14 hrs

A nurse is reviewing the medical record of a client who reports taking pseudoephedrine for sinus congestion as needed. The nurse should identify that this med contradictions which of the following conditions? a. eczema b. migraines c. hypertension

c. hypertension

A nurse is caring for a client who is taking montelukast. Which of the following outcomes indicates a therapeutic effect of this med? a. less muscle pain b. reduced seizure threshhold c. increased ease of breathing d. increased platelet count

c. increased ease of breathing

A nurse is presenting educational materials for a group of middle aged clients abou menopausal hormone therapy following total hysterectomy. Which of the following info should the nurse include? a. take at different times of the day b. take an extra dose if you missed a day c. prevents osteoporotic fractures

c. prevents osteoporotic fractures

A nurse is teaching a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? a. check pulse after admin b. take med with meals c. rinse mouth after admin d. limit caffeine intake

c. rinse mouth after admin

a nurse is teaching a client who is newly diagnosed with type 1 diabetes mellitus about self admin of insulin. Which of the following should the nurse include? a. pull back plunger after injecting b. massage injection after removing needle c. store the current bottle at room temp d. use each syringe up to 6 times

c. store the current bottle at room temp

A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. What adverse effect should the nurse instruct the client to report? a. sedation b. increases appetite c. white coating in the mouth d. Dry oral mucous membranes

c. white coating in the mouth

A nurse is caring for a client with diabetes mellitus who is prescribed regular insulin via a sliding scale. After admin the correct dose at0715, the nurse should ensure the client receives breakfast which of the following times? a. 0720 b.0730 c.0745 d. 0815

c.0745

histamine dilates small blood vessels in vascular system and is a CNS neurotransmitter that has the power to

constrict bronchi

inhalers are harder to

coordinate

A nurse is caring for.a client with diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcut at breakafast daily. What is the total number of units of insulin that the nurse should prepare in the syringe? a. 14 units b. 28 units c. 32 units d. 42 units

d. 42 units

A nurse is teaching a client about taking an expectorant to treat a cough. The nurse hsould explain that this type of med has which of the following actions. a. reduces inflammation b. suppresses urge to cough c. dries mucous membranes d. Stimulates secretions

d. Stimulates secretions

A nurse in an urgent care is caring for a client who is having an acute asthma exacerbation. What action should the nurse prioritize? a. initiating oxygen therapy b. providing rest for the client c. Position client in high fowlers d. admin a nebulized beta- adrenergic

d. admin a nebulized beta- adrenergic

A nurse is providing discharge instructions for a client who has asthma and a new prescription for montelukast. The nurse should instruct the client to report what adverse effect? a. blurred vision b. palpations c. Constipation d. depression

d. depression

A nurse is assessing a client who has thyrotoxicosis after taking too high level of levothyroxine. Which of the following manifestations should the nurse expect? a. drowsiness b. bradycardia c. dry skin d. heat intolerance

d. heat intolerance

A nurse is teaching a client who had diabetes and a new prescription for insulin glargine. Which of the following instructions should they provide? a. this med has a duration of 3-6 hrs b. this med has a duration of 6-10 hrs c. this med has a duration of 16-24 hrs d. this med has a duration of 18-24 hrs

d. this med has a duration of 18-24 hrs

Tamoxifen (nolvadex) increases risk for

endometrial cancer and thromboembolism

copper based IUD's are normally spermicidal and

hormone free

a TSH level under 0.3 indicates

hyperthyroidism

a TSH level over 6 indicates

hypothyroidism

it is dangerous for people with uteruses to take estrogen alone because

it increases risk for endometrial cancer

if theophylline is being taken, caffeine shouldn't be mixed with it because

it intesafies adverse effects

Oral antihistamines like allegra and benadryl do not relieve or reduce...

nasal congestions

sildenafil interacts with and should not be taken within 24 hours of

nitroglycerin or nitrates or vasodilators

Expectorants stimulate secretions and create more

productive coughs

Intranasal glucocorticoids are the most effective and first choice for prevention of

rhinitis

if pregnant it is more harmful to be hypothyroid than to

take the medicine so take the medicine!!

What is the downfall of using androgens in pregnancy?

the baby could take on male features if female

Raloxifene or Evista does not activate estrogen receptors but promotes

thromboemblism!!

Repaglinide has a 1 hour half life and is taken

with each meal